Drug Res (Stuttg) 2016; 66(12): 639-643
DOI: 10.1055/s-0042-112970
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Effectiveness of the Consecutive Alternating Administration Course of a Triple Antiviral Combination in Coxsackievirus B3 Infections in Mice

R. Vassileva-Pencheva
1   Department of Virology, The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
,
A. S. Galabov
1   Department of Virology, The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
› Author Affiliations
Further Information

Publication History

received 07 June 2016

accepted 13 July 2016

Publication Date:
23 August 2016 (online)

Abstract

Anti-enteroviral chemotherapeutics for clinical use are not registered so far, mainly due to the rapid development of drug-resistance. One of the possible approaches to overcome this problem is the use of combined chemotherapy. However, its application consisting of simultaneously given drugs, is not efficacious because of the development of multiple resistance. Here we present a novel approach for combined application of anti-enteroviral compounds, consisting of a consecutive alternating administration (CAA) course. CAA was tested on 2 in vivo models of Coxsackievirus B3 infection in newborn mice at inoculation dose of 20 MLD50 (50% mouse lethal dose): neurotropic (Nancy strain) and cardiotropic (Woodruff strain) infections. Compounds partnering in a triple combination were selected as enterovirus (EV) replication inhibitors with different mode of action – disoxaril (a VP1 blocker), guanidine.HCl (targeting 2C protein) and oxoglaucine (attacking 3A coding region). The application of this combination by CAA course resulted in around 40 and 60% survival rate in mice infected with Nancy and Woodruff virus, respectively, accompanied by a marked lengthening of the mean survival time (MST). The results obtained are proofs for the prospect of the treatment course by a triple combination through the CAA scheme as an approach interfering the occurrence of drug resistance at EV infections.

 
  • References

  • 1 Khetsuriani N, LaMonte-Fowlkes A, Oberste MS et al. Enterovirus surveiilance – United States, 1970–2005. CDC MMWR 2006; 55: 1-20
  • 2 Pallancsch MA. Enterovirus infections, including poliomyelitis. In: Guerrant RL, Walker DH, Weller PF. (eds.). Tropical Infectious Diseases, Principles. 3rd edn. Philadelphia, PA: Elsevier; 2011
  • 3 Tan WC. Viruses in asthma exacerbations. Current Opinion in Pulmonary Medicine 2005; 11: 21-26
  • 4 Mallia P, Contoli M, Caramori G et al. Exacerbations of asthma and chronic obstructive pulmonary disease (COPD): focus on virus induced exacerbations. Current pahrmaceutical Design 2007; 13: 73-97
  • 5 Galabov AS, Nikolaeva-Glomb L, Nikolova I et al. Perspectives for effective chemotherapy of enterovirus infections. In: Najdenski H, Angelova M, Stoitsova S. (eds.). New Ttrends in Microbiology (65th Anniversary of the Stephan Angeloff Institute of Microbiology). Sofia: The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, Ed.; 2012: 47-81
  • 6 Senior K. FDA panels rejects common cold treatment. Lancet Infect Dis 2002; 2: 264
  • 7 De Palma AM, Vliegen I, De Clercq E et al. Selective inhibitors of picornavirus replication. Med Res Rev 2008; 28: 823-884
  • 8 Prichard MN, Shipman Jr C. A three-dimentional model to analyze drug-drug interactions. Antiviral Res 1990; 14: 181-206
  • 9 Nikolaeva L, Galabov AS. Synergistic inhibitory effect of enviroxime and disoxaril on poliovirus type 1 replication. Acta virol 1995; 39: 235-241
  • 10 Nikolaeva L, Galabov AS. In vitro inhibitory effects of dual combinations of picornavirus replication inhibitors. Acta virol 1999; 43: 303-311
  • 11 Nikolaeva L, Galabov AS. Antiviral combined effects of enviroxime and disoxaril in coxsackievirus B1 infection. Acta virol 2000; 44: 73-78
  • 12 Nikolaeva L, Galabov AS. Synergistic drug combinations against the in vitro replication of Coxsackie B1 virus. Antiviral Res 2004; 16: 1-46
  • 13 Vassileva-Pencheva R, Galabov AS. Avoiding drug – resistance development by novel approach of combining anti-enteroviral substances against coxsackievirus B1 infection in mice. Antiviral Res 2010; 85: 366-372
  • 14 Pevear DC, Tull TM, Seipel ME et al. Activity of pleconaril against enteroviruses. Antimicrob Agents Chemother 1999; 43: 2109-2115
  • 15 Melnick JL, Crowther D, Barrera-Oro J. Rapid development of drug-resistant mutants of poliovirus. Science 1961; 134: 557
  • 16 Loddo B. Development of drug resistance and dependence in viruses. Pharm Ther 1980; 10: 431-460
  • 17 Nikolova V, Galabov AS. Development of resistance to disoxaril in Coxsackie B1 virus-infected newborn mice. Antiviral Res 2003; 60: 35-40
  • 18 Diana GD, Pevear DC, Otto MJ et al. Inhibitors of viral uncoating. Pharm Ther 1989; 42: 289-305
  • 19 Smith TJ, Kremer MJ, Luo M et al. The site of attachment in human rhinovirus 14 for antiviral agents that inhibit uncoating. Science 1986; 233: 1286-1293
  • 20 Rossmann MG. The structure of antiviral agents that inhibit uncoating when complexed with viral capsids. Antiviral Res 1989; 11: 3-14
  • 21 Pfister T, Wimmer E. Characterization of the nucleoside triphosphatase activity of poliovirus protein 2C reveals a mechanism by which guanidine inhibits poliovirus replication. J Biol Chem 1999; 274: 6992-7001
  • 22 Nikolaeva-Glomb L, Philipov S, Galabov AS. A new highly potent antienteroviral compound. In: Georgiev VSt, Western KA, McGowan JJ. (eds.). National Institute of Allergy and Infectious Diseases, NIH, Vol. 1 “Frontiers in Research”. Totowa, NJ: Humana Press; 2008: 99-202
  • 23 Arita M, Philipov S, Galabov AS. Phosphatidylinositol 4-kinase III beta is the target of oxoglaucine and pachydipol (Ro 09-0179) for their anti-poliovirus activity, and locates at upstream of the target step of brefeldin A in poliovirus replication. Microbiol Immunol 2015; 59: 338-347
  • 24 Stoyanova A, Nikolova I, Galabov AS. Effect of consecutive alternative administration (CAA) of a triple anti-enteroviral combination on Coxsackievirus B1 neuroinfection in mice. Antivir Res 2015; 121: 138-144